Women failing to attend smear tests

NHS nurses would be compassionate in those circumstances

Another patient's family member once, justifiably, made a complaint about the way I was treated by an the nurses on a ward in an NHS hospital.

In the main they do a wonderful job, but they are only people and they carry their own prejudices.

So you cannot state that they, categorically, would all treat women compassionately.

NHS nurses would be compassionate in those circumstances

Nurses should be compassionate in all circumstances, but I think that goal is unrealistic.

Couldn't agree more whiskyowl.

whiskyowl

Yes GP's can be problematic. I think education is definitely the key, finding a way that appeals to younger women. I'm just reading a study about increasing uptake of screening by Roma women in Romania where uptake is a real issue.

"Yes and yet there are calls from this age group to lower the age because some have unfortunately died. I wonder if the hpv vaccine will make a very large difference in the future??"

Yes. The trouble is, those calls aren't especially helpful. It's absolutely tragic when a young woman in her early 20s dies of cervical cancer. It's appalling. And naturally, family and friends want to know why. The absence of screening for this age group seems like an obvious place to look. But unfortunately, it's not the answer - the current method of screening just isn't effective as a way of finding cases of cancer in this demographic, basically because so many of them are HPV positive.

What you do find, however, if you look through the case notes of these tragedies, is that GPs are missing tell-tale symptoms. Some of these women go back and back and back to the doctor, knowing something is wrong and are not referred on for symptomatic testing (a process that is separate from screening). We need to educate GPs better on this issue to ensure that this doesn't happen. (In my personal opinion, we need a revolution on GP attitudes to gynae health full stop - the level of flouting of NICE guidelaines when it comes to things like menhorragia is appalling).

vegecook b12 supplementation and retesting has raised and confirmed my b12 levels. I'll never know the exact cause for why they dropped low but I can prevent them from dropping so low again.

And YOU are trying to silence those of us who agree with screening and have NO issues with it, why can't you see that???

Because I'm not and you've entirely invented that. Quote me even one post of mine where I've done that. Hint- telling people not to make false equivalences isn't it.

While you're looking, pay a bit of attention to the posts where I've talked about things that could be done to assist women who do want screening and are having problems accessing it.

whiskyowl
Yes and yet there are calls from this age group to lower the age because some have unfortunately died. I wonder if the hpv vaccine will make a very large difference in the future??

Do you mean how do I think women between the ages of 25 and 40 could be encouraged to go? I think public health as a whole does a poor job of 'marketing' in this country. I would like to see a more dedicated unit, probably within PHE, to promote campaigns using more innovative and 'young' methods, and I don't just mean 'Change for Life' type stuff. They can do better than that. I also think the information provided for women online has gone downhill - having public health information on a highly official looking .gov site is a disaster. The people who were responsible for this are arrogant idiots (they were told, they didn't listen).

Of course, cervical screening isn't available to those under 25 'coz it isn't effective!

whiskyowl

Thanks for your input. So what do you think can be done to get younger women into screening?

Also, Barracker not to derail but how do you know you will no longer have B12 deficiency. I have it for life. Not being goody just genuinely interested.

Yes, it is batteries and we know there is a link between low B12 and cervical cancer incidence, so you might well be right!

I used to work at a national level in screening policy, but don't any more.

Yes, I do support cervical cancer screening, I think it's a wonderful programme that's saved an awful lot of lives with comparatively low levels of harm, and promises to have a very bright future in saving a load more. At the same time, I am an advocate for individual women to make their own informed choice about whether they want to participate. I would advise any woman to do so, but it is her personal choice at the end of the day.

I had abnormal results until I was diagnosed with Pernicious Anaemia (B12 Deficiency) and started having B12 injections. I told my Doctor about this and she's never heard of it so I thought it was a coincidence.

B12 is important in immune system health isn’t it? So low B12 could cause a HPV flare up possibly. Or be correlated if not causative. Maybe. I’m not a medical professional!

whiskyowl

Are you a medical professional? And do you support cervical cancer screening?

PramWanker

And YOU are trying to silence those of us who agree with screening and have NO issues with it, why can't you see that??? I have acknowledged that some may struggle so why can't you acknowledge that for many it's a unfortunate unloved but necessary function to protect our health.

Barracker - there are MANY different kinds of abnormal cervical cytology. It's really easy to confuse different types - there's a whole manual for histologists on distinguishing between the different kinds of 'slightly wrong epithelial cells'! However, the cervical screening programme is supposed to screen for HPV-associated changes. Things can still go wrong - there can be mistakes, false positives etc. (particularly as its really easy to confuse some types of these changes).

To explain the HPV thing again:

• you can get HPV and your body will respond without you being aware of it. This may well cause cellular abnormalities i the cervix, and you will screen as HPV positive.
• the HPV infection can then be cleared,. You may have lingering cellular abnormalities that gradually clear (or you may have none at all). You will screen as HPV negative
• the HPV infection can lie dormant, in which case you will have no HPV-associated cellular abnormalities and will screen HPV negative
• the HPV infection can be reactivated, and flare again, in which case you will have cellular abnormalities and screen as HPV positive. A flare isn't necessarily any more worrying than an initial infection - the problem arises when the infection persists in an active state for some time, and goes on causing more and more changes.

You could have been infected 11 years ago, and had a flare. Or it could be that a mistake was made and cellular changes associated with B12 deficiency were mistaken by a screener for HPV-associated changes. In either case, the important thing is that there would be no need for you to worry!

I'm afraid the point at which you got to lecture anyone about civil discussion and being delights has long since passed walking. Your attitude during this thread has been such that any criticism from you functions only as a compliment. I'd be saddened to receive the good opinion of someone who tries to silence women for speaking their truth about smear tests.

Whiskyowl it seems vanishingly unlikely that I've picked up a recent infection.
I've been married for 11 years to the same man. If he infected me it would have been eleven years ago, not recently.

"Only an active HPV infection is picked up or causes cellular abnormalities."

Clearly that statement is not true. I'm a living example of that, and there are numerous examples of other causes of abnormal cells which present in the absence of HPV. B12 deficiency being a well documented one.

The fact that there is speculation by us here suggests it would be helpful if better information was available to us.

PramWanker

You really are a delight aren't you???? Incapable of civil discussion, pot kettle and black much.......

Really? So No it fucking well isn't doesn't come across as angry? I've been called a liar and told I'm not entitled to say people on both sides are coming across as angry.

Well you're either lying about that last point granny or simply not understanding it, because you most certainly haven't been told you're not entitled to say that. You just haven't. Telling you not to pretend that the anger is equivalent to the anger plus the other stuff that is heaped on women opting out is not the same thing.

It would be interesting to see which posts you were talking about when you referred to that anger upthread aimed at those who have talked about it not being painful, though. It can't have been mine to walking when I said no it fucking well isn't, because that was posted after your claim. Not that I make any apologies at being angry at her for being so utterly repellent, mind.

But I have acknowledged those things...maybe try re reading when I have done that?? Cos I truly cannot be bothered.

The takeaway message from some is that there is no point, as rates of cervical cancer are so low, it is excruciatingly painful (not for all), and doctors push it to get funding. That is a very dangerous message for some to be portraying. A balanced approach is necessary in order to have informed consent. I don't care if some of you have smears, but I do care when impressionable young women are being told that cervical smears are unnecessary.

If you are literally telling women to stop talking about those things walking, which is precisely what you're doing when you say it's sheer bloody mindedness to portray the issue in the way some posters have, any acknowledgement that you may have offered becomes meaningless.

It is true that surgeries are offered funding initiatives for smears. It is true that rates are low. It is true that some women find it painful. It is irresponsible to try and silence women discussing this.

whiskyowl

That's interesting. At my 2 last smears I tested negative for hpv but as it has been estimated that up to 98% of population have it I still worry that I have had it and it's just laying dormant, which is why I still go for my smears. There appears to be a lot we still don't know about hpv?

There is a phone number for a nurse practitioner in the letter, I think? At least, there used to be! Any woman who is concerned should give them a bell - most of them are absolutely brilliant.

Theresa May has just acknowledged smear tests can be uncomfortable in PMQs. I wonder if she has read the thread.